Kesebir Sermin, Koc Merve Iris, Yosmaoglu Ahmet
Department of Psychiatry, Uskudar University, NPIstanbul Brain Hospital, Istanbul, Turkey.
Uskudar University, NPIstanbul Brain Hospital, Istanbul, Turkey.
J Clin Med Res. 2020 Apr;12(4):251-254. doi: 10.14740/jocmr4143. Epub 2020 Mar 30.
This study aims at investigating into the presence of family history of diabetes, ischemic heart disease, thyroid disease, cancer, cerebrovascular disease, and epilepsy in bipolar patients.
Totally 1,148 patients admitted to our outpatient unit between January 2018 and January 2020, who were diagnosed with bipolar disorder according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V), from whom informed consent was obtained, were cross-sectionally and consecutively evaluated. Each patient was questioned regarding a family history of diabetes, ischemic heart disease, thyroid disease, cancer (gastrointestinal, breast and prostate cancer, leukemia, and lymphoma), cerebrovascular disease and epilepsy in first- and second-degree relatives.
Diabetes, ischemic heart disease, cancer, cerebrovascular disease and epilepsy were more common in the family histories than in bipolar patients. A strong correlation was found between family history positive for epilepsy and bipolar disorder with psychotic symptoms. Also, a correlation was found between family history for diabetes and seasonal course and family history positive for thyroid disease and comorbid anxiety disorder.
This study is the first to investigate into the frequency of physical diseases in the family histories of bipolar patients. Current therapies target the association between common leading pathways and symptoms whereas it is the association between stress and neural circuits that underlie the pathophysiology that should be targeted.
本研究旨在调查双相情感障碍患者中糖尿病、缺血性心脏病、甲状腺疾病、癌症、脑血管疾病和癫痫的家族病史情况。
对2018年1月至2020年1月期间在我院门诊就诊的1148例患者进行横断面连续评估,这些患者根据《精神疾病诊断与统计手册》第五版(DSM-V)被诊断为双相情感障碍,并获得了知情同意。询问每位患者关于一级和二级亲属中糖尿病、缺血性心脏病、甲状腺疾病、癌症(胃肠道、乳腺癌和前列腺癌、白血病和淋巴瘤)、脑血管疾病和癫痫的家族病史。
糖尿病、缺血性心脏病、癌症、脑血管疾病和癫痫在家族病史中比在双相情感障碍患者中更为常见。发现癫痫家族史阳性与伴有精神病性症状的双相情感障碍之间存在强相关性。此外,发现糖尿病家族史与季节性病程之间以及甲状腺疾病家族史阳性与共病焦虑障碍之间存在相关性。
本研究首次调查了双相情感障碍患者家族病史中躯体疾病的发生频率。目前的治疗方法针对的是常见主要通路与症状之间的关联,而应激与神经回路之间的关联才是病理生理学的基础,应该针对这一点进行治疗。